For Dossia, Digital Health Isn't Just Personal Anymore

At Boston-based Dossia, it’s not just personal anymore. The digital health start-up was early in the race to build a lifelong and portable personal health record. It’s backers read like a who’s who among Fortune 500 companies – Walmart,
Intel,
Applied Materials, Pitney-Bowes and
BP America among them. Dossia first rolled out its personal health record (PHR) platform in 2008, at roughly the same time as
Google Health. It started modestly with a pilot for Walmart employees, but eventually aimed to connect the 2.5 million employees, dependents and retirees receiving health benefits through its founding partners. But as is often the case with digital health start-ups, getting the stars to align is just one of many Herculean tasks. As even Google learned in its fleeting romance with PHR’s, if the vicissitudes of a hugely complex $2.7 trillion health care industry don’t snuff you out, an anemic consumer market almost assuredly will.

Dossia was always sober to the realities of treading into unchartered PHR waters. And like the venerable team at Google Health, Dossia’s executives learned early on that capital and a good idea, even a noble one, will only take you so far.

But unlike Google, Dossia is still very much in the game. Having spent the last few years mending wounds inflicted by two failed technology partners, Dossia now appears poised to gain the ground Google ceded, moving well beyond personal health management and setting its sights on population health.

"We’ve learned from the industry’s mistakes as well as our own,” said David Goldsmith, executive director of the Dossia Consortium, the company’s not-for-profit arm.

David Goldsmith

"We recognize now that personal and population health must go hand-in-hand and that building towards value-based health care requires us to focus not on one or the other, but both."

At first blush, Dossia’s shift towards population health looks like a classic start-up pivot. But for Goldsmith, it’s a logical evolution. “If there’s been one constant at Dossia over the years, it’s the ability to adapt to the harsh realities of an industry that requires health technology start-ups to either mutate or die,” Goldsmith said. “We know now that unlocking the real value of PHR’s resides in our ability to use data to engage the right patient at the right time.”

To get there, Dossia is rolling out a suite of population health management tools that aggregate its members’ PHR data and utilize evidence-based health rules to drive personalized interventions. These are tied to specific “triggers” that are known to motivate people at times when they are much more likely to act on their health. For example, an individual turning 50 will receive a notification from a health coach encouraging them to get screened for colorectal cancer. “It’s the difference between a shotgun and a scalpel” Goldsmith said. “Population health managers can now use our dashboard to monitor key metrics in near real-time and use pre-defined triggers to make the PHR data actionable at scale.”

In health care, real-time makes a real difference. Many of today’s health and wellness companies rely mostly on historical medical claims data, which can easily be more than 90 days old. By contrast, Dossia leverages the muscle of large self-insured employers and works with third-party administrators to ingest health data as soon as it's supplied by the provider. This enables Dossia to populate its PHR using unadjudicated claims data from physicians, hospitals and PBMs. Depending on the individual, the PHR may also include biometric data streamed from mobile apps and connected health devices such as activity trackers, glucometers and wireless scales.

For the 60% of U.S.-based employers that invest in workplace wellness programs, Dossia’s new population health capabilities could be a game-changer. Only time will tell. But for now, Dossia’s embrace of both personal and population health may prove to be its smartest mutation yet.

I am the Founder of NOSTALAB -- a leading digital health think tank providing business and marketing insights to help the life science industry navigate the complex aspects of innovation in the context of exponential change. I help define, dissect and deliberate global tren...